MW The current Republican tax bill could cut $500 billion from Medicare - 'This bill just gets more and more cruel'

By Jessica Hall

Medicare provides health insurance for about 68 million older adults and people with disabilities

The nonpartisan Congressional Budget Office $(CBO)$ estimated that the Republican budget bill under consideration would trigger about $500 billion in automatic cuts to Medicare, the program that provides health insurance to around 68 million older adults and people with disabilities.

This is because Congress is bound by the statutory Pay-As-You-Go ('PAYGO') Act, which requires any spending to be offset by automatic cuts, to avoid deficit spending. The automatic Medicare reductions are capped at 4% of its yearly budget. Therefore, the cuts to Medicare would total about $45 billion in 2026 and $490 billion between 2027 and 2034, according to the CBO letter. Unless lawmakers otherwise offset the deficit impact of the Republican bill or agree to waive the PAYGO requirements, the cuts would be automatically triggered.

Overall, the Republican tax bill, known as the One Big Beautiful Bill Act, would add $2.3 trillion to the deficit over 10 years, according to the CBO.

The Medicare cuts are not guaranteed because Congress has various alternatives, such as changing the federal budget scorekeeping rules or instructing the White House budget office to disregard the reconciliation package's debt impact, according to The Washington Post.

The cuts to Medicare, which provides federal health insurance for people 65 or older and those with disabilities, would come in addition to roughly $600 billion in proposed cuts to Medicaid, which is a joint federal and state program that helps cover medical costs for people with low income.

"They're not just cutting Medicaid," Rep. U.S. Teresa Leger Fernández (D-N.M.) said on X. "They're cutting Medicare too."

President Trump had campaigned on a promise to protect Medicare. The White House did not immediately respond to a request for comment.

"This bill just gets more and more cruel," said Richard Fiesta, executive director of the advocacy group Alliance for Retired Americans. "It is an all-out assault on Medicare and Medicaid that will hurt older Americans in every community across the country."

"President Trump and Speaker Johnson promised over and over not to touch Medicare. This big, brutal bill cuts both Medicare and Medicaid while handing massive tax breaks to the ultra-wealthy and big corporations," Fiesta said. "This is not just a broken promise - it's a betrayal."

"This Republican budget bill is one of the most expensive - and dangerous - bills Congress has seen in decades," said U.S. Rep. Brendan Boyle (D-Pa.), the top Democrat on the House Budget Committee. "The nonpartisan CBO makes it clear: The deficit will explode so badly it will trigger automatic cuts, including over half a trillion dollars from Medicare."

"This is what Republicans do - pay for massive tax breaks for billionaires by going after programs families rely on the most: Medicaid, food assistance, and now Medicare," Boyle added. "It's reckless, dishonest, and deeply harmful to the middle class."

Mary Johnson, an independent Medicare and Social Security analyst, said the cuts to Medicare would affect beneficiaries, as well as the program's ability to check on waste, fraud and abuse - a fight the Trump administration has championed.

"Ironically one of the first areas that have felt the cuts in the past have been Medicare's fraud, and waste-fighting efforts. These cuts would weaken the key Trump administration priority to root out fraud and waste. It could backfire by leading to a more rapid rate of growth in Medicare Part B premiums if waste and fraud is not kept in check," Johnson said.

"A $500 billion Medicare cut is very substantial, could affect the ability of Medicare's tens of millions of retired and disabled beneficiaries to access health care," Johnson said.

-Jessica Hall

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May 21, 2025 14:18 ET (18:18 GMT)

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